Req Number 001U9I
Job Category Managed Care
Directs the administration and coordination of daily operations for quality improvement programs and initiatives; assist members with the implementation of strategies to improve the patient care experience, healthy outcomes, and healthcare values. Works directly with members and external stakeholders to accelerate the adoption of evidence-based practices and achieve provider-specific and aggregate improvement objectives.
Participates in the implementation of assigned programs and services to improve members’ quality and efficiency performance.
Identifies, develops and evaluates quality improvement initiatives.
Assists in coordination and evaluation of educational programs and activities to improve quality and patient safety.
Serves as key liaison between strategic partners and member participants to support implementation and integration of performance and quality improvement processes to optimize patient outcomes, enhance operational effectiveness and facilitate healthy communities.
Provides members’ guidance and support for data collection, analysis and performance measurement to facilitate improved patient outcomes and organizational efficiencies.
Monitors members’ performance data, identifies improvement trends and opportunities, and presents findings to senior leadership and members as appropriate.
Ensures program compliance with all applicable laws, contracts, regulations, and professional and educational standards.
Serves on member committees, task forces, and peer networks as appropriate.
Selects, develops, manages and evaluates direct reports. Ensures performance appraisals are completed in a timely fashion.
Develops an effective intra-disciplinary communications process within the department, across the Health System, outside business partners and vendors to optimize operations.
Assists in the review, revision, development, coordination and integration of policies and procedures.
Performs related duties, as required.
*ADA Essential Functions
• Bachelor’s Degree in Healthcare Administration, Public Health or related field, required.
• Minimum of seven (7) years related quality and performance improvement experience, required.
• Strong negotiation and coalition skills to effectively facilitate work group meetings.
• Proven expertise in project planning, task prioritization, outcomes measurement and monitoring.
• Knowledge of medical terminology, health information technology, and current regulatory and accreditation standards in health care services.
• Basic understanding of quantitative and qualitative measurement, analytics and evaluation including the use of statistical process control in healthcare.
• Excellent written and verbal communication skills. Strong working knowledge of Microsoft Office Suite products.